Challenges and opportunities to improve tuberculosis care for Indonesian children
Keywords:
tuberculosis; child; detect; treat; prevent
Abstract
No abstract for editorial
References
1. Global tuberculosis report 2024. Geneva: World Health Organization; 2024. [cited 2024 Nov 12]. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2024
2. Kementerian Kesehatan Republik Indonesia. Revised national strategy of tuberculosis care and prevention in Indonesia 2020-2024 and interim plan for 2025-2026. [cited 2025 Jan 5]. Available from: https://www.tbindonesia.org.id/wp-content/uploads/2024/02/Revised-NSP-TB-2020-2024-and-interim-plan-2025-2026_final_ttd-1.pdf
3. Martinez L, Cords O, Horsburgh CR, Andrews JR; Pediatric TB Contact Studies Consortium. The risk of tuberculosis in children after close exposure: a systematic review and individual-participant meta-analysis. Lancet. 2020;395:973-84. DOI: https://doi.org/10.1016/S0140-6736(20)30166-5
4. Noviyani A, Nopsopon T, Pongpirul K. Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia. PLoS ONE. 2021;16:e0258809. DOI: https://doi.org10.1371/journal.pone.0258809
5. Kementerian Kesehatan Republik Indonesia and WHO. Indonesia TB Joint External Monitoring Mission Report, 4-15 December 2022. [cited 2024 Dec 4]. Available from: https://domes.un.or.id/api/v1/download?filename=keshif/474cac0e-8df0-449b-a771-f2bcde6056d6.pdf
6. WHO consolidated guidelines on tuberculosis. Module 5: Management of tuberculosis in children and adolescents. Geneva: World Health Organization; 2022 [cited 2024 Dec 6]. Available from: https://www.who.int/publications/i/item/9789240046764
7. WHO operational handbook on tuberculosis. Module 5: Management of tuberculosis in children and adolescents. Geneva: World Health Organization; 2022 [cited 2024 Dec 6]. Available from: https://www.who.int/publications/i/item/9789240046832
8. Olbrich L, Franckling-Smith Z, Larsson L, Sabi I, Ntinginya NE, Khosa C, et al; RaPaed-AIDA-TB consortium. Sequential and parallel testing for microbiological diagnosis of tuberculosis disease in children in five low-income and middle- income countries: a secondary analysis of the RaPaed-TB study. Lancet Infect Dis. 2024:S1473-3099(24)00494-8. DOI: https://doi.org/10.1016/S1473-3099(24)00494-8
9. Chani K, Athallah A, Colquhoun S, Tsheten T, Huang K, Chirenda J, et al. Proportions of Xpert Ultra trace result vary widely among populations with presumptive tuberculosis: a systematic review. Int J Tuberc Lung Dis . 2025 (in press)
10. Lestari BW, Mc Allister S, Hadisoemarto PF, Afifah N, Jani ID, Murray M, et al. Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia. Lancet Reg Health West Pac. 2020;5:100059. DOI: https://doi.org/10.1016/j.lanwpc.2020.100059
11. Lestari BW, Hadisoemarto PF, Afifah N, McAllister S, Fattah D, Salindri AD, et al. Tuberculosis care provided by private practitioners in an urban setting in Indonesia: Findings from a standardized patient study. PLoS Glob Public Health. 2024;4:e0003311 DOI: https://doi.org/10.1371/journal.pgph.0003311
12. de Haas P, Nhung NV, Hng NT, Hoà NB, Loan NB, Thanh NTK, et al. Introduction of the simple one-step stool Xpert Ultra method to detect TB in children and adults. Int J Tuberc Lung Dis 2023;27:19-27. DOI: https://doi.org/10.5588/ijtld.22.0161
13. Mafirakureva N, Klinkenberg E, Spruijt I, Levy J, Shaweno D, de Haas P, et al. Xpert Ultra stool testing to diagnose tuberculosis in children in Ethiopia and Indonesia: a modelbased cost-effectiveness analysis. BMJ Open. 2022;12:e058388. DOI: https://doi.org/10.1136/bmjopen-2021-058388
14. Evident Indonesia. Evaluasi dan demonstrasi modalitas diagnostik baru untuk penyakit tuberkulosis di Indonesia. [cited 2024 Dec 9]. Available from: www.evident.rc3id.unpad.ac.id
15. The Union. Diagnosis and management of tuberculosis in children and adolescents. A desk guide for primary health care workers. Fourth edition. 2023. Graham SM, Oliwa JN. [cited 2024 Dec 6]. Available from: https://theunion.org/sites/default/files/2023-02/Child%20TB%20Desk%20Guide%202023_Asia.pdf
16. Gunasekera K, Marcy O, Munoz J, López-Varela E, Sekadde MP, Franke MF, et al. Development and validation of treatment-decision algorithms for children evaluated for pulmonary tuberculosis: an individual participant data meta-analysis. Lancet Child Adol Health, 2023;7:336-46. DOI: https://doi.org/10.1101/2022.09.13.22279911
17. Hatherill M, Hanslo M, Hawkridge T, Little F, Workman L, Mahomed H, et al. Structured approaches for the screening and diagnosis of childhood tuberculosis in a high prevalence region of South Africa. Bull World Health Organ. 2010;88:312-20. DOI: https://doi.org/10.2471/BLT.09.062893
18. Triasih R, Graham SM. Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation. Paediatr Indones. 2011;51:332-37. DOI: https://doi.org/10.14238/pi51.6.2011.332-7
19. Chabala C, Roucher C, Ton Nu Nguyet MH, Babirekere E, Inambao M, et al. Development of tuberculosis treatment decision algorithms in children below 5 years hospitalised with severe acute malnutrition in Zambia and Uganda: a prospective diagnostic cohort study. EClinMed. 2024;73:102688. DOI: https://doi.org/10.1016/j.eclinm.2024.102688
20. Triasih R, Yani FF, Wulandari DA, Nababan B, Ardiyamustaqim MB, Meyanti F, et al. Treatment-decision algorithm of child TB: evaluation of WHO algorithm and development of Indonesia algorithm. Trop Med Int Health. 2025. Not peer-reviewed version. DOI: https://doi.org/10.20944/preprints202501.0256.v1
21. du Preez K, Gabardo BMA, Kabra SK, Triasih R, Lestari T, Kal M, et al. Priority activities in child and adolescent tuberculosis to close the policy-practice gap in low- and middle-income countries. Pathogens. 2022;11:196 DOI: https://doi.org/10.3390/pathogens11020196
22. The Union. Diagnostic CXR atlas for tuberculosis in children. A guide to chest X-ray interpretation. Second Edition. 2022. Palmer M, Seddon JA, Goussard P, Schaaf HS. [cited 2025 Jan 5]. Available from: https://theunion.org/sites/default/files/2022-03/The%20Union_Diagnostic%20Atlas%20for%20TB%20in%20Children_2022.pdf
23. The Union. Online course for interpretation of CXRs in children with presumptive TB. [cited 2024 Oct 10]. Available from: https://coursesonline.theunion.org/theunion/2023/interpretation-of-chest-x-rays-in-children-with-tb/393947
24. The Union. Diagnostic CXR atlas for tuberculosis in children - image library. [cited 2024 Oct 10]. Available from: https://atlaschild.theunion.org/
25. The Union. Atlas radiografi toraks untuk diagnosis tuberkulosis pada anak. Sebuah panduan untuk interpretasi radiografi toraks. Edisi kedua. 2022. [cited 2024 Oct 10]. Available from: https://theunion.org/technical-publications/diagnostic-cxr-atlas-for-tuberculosis-in-children-bahasa-indonesia Accessed October 10, 2024.
26. Palmer M, Seddon JA, van der Zalm MM, Hesseling AC, Goussard P, Schaaf HS, et al. Optimising computer aided detection to identify intra-thoracic tuberculosis on chest x-ray in South African children. PLoS Glob Public Health. 2023;3:e0001799. DOI: https://doi.org/10.1371/journal.pgph.0001799
27. Edem VF, Nkereuwem E, Agbla SC, Owusu SA, Sillah AK, Saidy B, et al. Accuracy of CAD4TB (Computer Aided Detection for Tuberculosis) on paediatric chest radiographs. Eur Respir J. 2024;64:2400811. DOI: https://doi.org/10.1183/13993003.00811-2024
28. Zawedde-Muyanja S, Nakanwagi A, Dongo JP, Sekadde MP, Nyinoburyo R, Ssentongo G, et al. Decentralisation of child tuberculosis services increases case finding and uptake of preventive therapy in Uganda. Int J Tuberc Lung Dis. 2018;22:1314-21. DOI: https://doi.org/10.5588/ijtld.18.0025
29. Lestari T, Kamaludin, Lowbridge C, Kenangalem E, Poespoprodjo JR, Graham SM, et al. Impacts of tuberculosis services strengthening and the COVID-19 pandemic on case detection and treatment outcomes in Mimika District, Papua, Indonesia: 2014-2021. PLoS Glob Pub Health. 2022;2:e0001114. DOI: https://doi.org/10.1371/journal.pgph.0001114
30. OpenWHO.e-course Management of tuberculosis in children and adolescents for health care workers. [cited 2024 Oct 20]. Available from: https://openwho.org/courses/TB-child-adolescent-EN
31. OpenWHO. E-learning course on TB in children and adolescents: programmatic considerations. [cited 2024 Oct 20]. Available from: https://openwho.org/courses/TB-child-adolescent-programmatic
32. The Union. Management of Child and Adolescent TB, Union Courses Online. [cited 2024 Dec 6]. Available from: https://coursesonline.theunion.org/
33. Badan Kebijakan Pembangunan Kesehatan, Kementrian Kesehatan RI. Buku Saku Hasil Survei Status Gizi (SSGI) 2022. [cited 2025 Jan 5]. Available from: https://drive.google.com/file/d/1v6ceJlVFCVCBedrzbdDNCj6T4ZbadVBi/view
34. Chisti MJ, Graham SM, Duke T, Ahmed T, Ashraf H, Faruque ASG, et al. A prospective study of the prevalence of tuberculosis and bacteraemia in Bangladeshi children with severe malnutrition and pneumonia including an evaluation of Xpert MTB/RIF assay. PLoS One. 2014;9:e93776 DOI: https://doi.org/10.1371/journal.pone.0093776
35. Podewils LJ, Holtz T, Riekstina V, Skripconoka V, Zarovska E, Kirvelaite G, et al. Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients. Epidemiol Infect. 2011;139:113-120. DOI: https://doi.org/10.1017/S0950268810000907
36. Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M, et al. Nutritional status of adult patiens with pulmonary tuberculosis in rural central India and its association with mortality. PLoS One. 2013;8:e77979. DOI: https://doi.org/10.1371/journal.pone.0077979
37. Hoyt KJ, Sarkar S, White L, Joseph NM, Salgame P, Lakshminarayanan S, et al. Effect of malnutrition on radiographic findings and mycobacterial burden in pulmonary tuberculosis. PLoS One. 2019;14:e0214011. DOI: https://doi.org/10.1371/journal.pone.0214011
38. Putri FA, Burhan E, Nawas A, Soepandi PZ, Sutoyo DK, Agustin H, et al. Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia. Int J Tuberc Lung Dis. 2014;18:564-570. DOI: https://doi.org/10.5588/ijtld.13.0602
39. Bhargava A, Bhargava M, Meher A, Benedetti A, Velayutham B, Sai Teja G, et al. Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial. Lancet. 2023;402:627-40. DOI: https://doi.org/10.1016/S0140-6736(23)01231-X Erratum in: Lancet. 2024;404:340. DOI: https://doi.org/10.1016/S0140-6736(24)01500-9
40. Bhargava A, Bhargava M, Meher A, Teja GS, Velayutham B, Watson B, et al. Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India. Lancet Glob Health. 2023;11:e1402-e1411. DOI: https://doi.org/10.1016/S2214-109X(23)00324-8
41. Obimbo Maleche E, Atieno Odhiambo M, Njeri L, Mburu M, Jaoko W, Were F, et al. Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries: a systematic review and meta-analysis. PLoS Glob Public Health. 2022;2:e0000805 DOI: https://doi.org/10.1371/journal.pgph.0000805
42. Martinez L, Gray DM, Botha M, Nel M, Chaya S, Jacobs C, et al. The long-term impact of early-life tuberculosis disease on child health: A prospective birth cohort study. Am J Respir Crit Care Med. 2023;207:1080-8. DOI: https://doi.org/10.1164/rccm.202208-1543OC
43. Nkereuwem E, Agbla S, Njai B, Edem VF, Jatta ML, Owolabi O, et al. Post-tuberculosis respiratory impairment in Gambian children and adolescents: A cross-sectional analysis. Pediatr Pulmonol. 2024;59:1912-21. DOI: https://doi.org/10.1002/ppul.27009
44. du Preez K, Jenkins HE, Martinez L, Chiang SS, Dlamini SS, Dolynska M, et al. The global burden of tuberculous meningitis in children aged 0-14 years: a mathematical modelling study. Lancet Glob Health. 2025;13:e59-e68. DOI: https://doi.org/10.1016/S2214-109X(24)00383-8
45. Wasserman S, Donovan J, Kestelyn E, Watson JA, Aarnoutse RE, Barnacle JR, et al. Advancing the chemotherapy of tuberculous meningitis: a consensus view. Lancet Infect Dis. 2025;25:e47-e58. DOI: https://doi.org/10.1016/S1473-3099(24)00512-7 Erratum in: Lancet Infect Dis. 2025;25:e13. DOI: https://doi.org/10.1016/S1473-3099(24)00829-6
46. WHO consolidated guidelines on tuberculosis. Module 1: Prevention - tuberculosis preventive treatment. Second edition. Geneva: World Health Organization; 2024 [cited 2024 Jan 5]. Available from: https://www.who.int/publications/i/item/9789240096196
47. Martinez L, Cords O, Liu Q, Acuna-Villaorduna C, Bonnet M, Fox GJ, et al. Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis. Lancet Glob Health. 2022;10:e1307-e1316. DOI: https://doi.org/10.1016/S2214-109X(22)00283-2
48. Kementerian Kesehatan Republik Indonesia. Annual Report Immunization 2022. [cited 2024 Dec 6]. Available from: https://p2p.kemkes.go.id/wp-content/uploads/2023/12/FINAL_231123_Layout_Imunisasi_Bahasa-Inggris.pdf
49. Tait DR, Hatherill M, Van Der Meeren O, Ginsberg AM, Van Brakel E, Salaun B, et al. Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis. N Engl J Med. 2019;381:2429-39. DOI: https://doi.org/10.1056/NEJMoa1909953
50. Late-stage trial for tuberculosis vaccine candidate underway in South Africa. [cited 2024 Oct 11]. Available from: https://wellcome.org/news/late-stage-trial-tuberculosis-vaccine-candidate-underway-south-africa
51. Martinez L, Seddon JA, Horsburgh CR, Lange C, Mandalakas AM; TB Contact Studies Consortium. Effectiveness of preventive treatment among different age groups and Mycobacterium tuberculosis infection status: a systematic review and individual-participant data meta-analysis of contact tracing studies. Lancet Resp Med 2024;12:633-41. DOI: https://doi.org/10.1016/S2213-2600(24)00083-3
52. Fox GJ, Nguyen VN, Nguyen CB, Nguyen BH, Garden FL, Benedetti A, et al. Levofloxacin for the prevention of multidrug-resistant tuberculosis in Vietnam. New Engl J Med. 2024;391:2304-14. DOI: https://doi.org/10.1056/NEJMoa2314325
53. Bonnet M, Vasiliu A, Tchounga BK, Cuer B, Fielding K, Ssekyanzi B, et al. Effectiveness of a community-based approach for tuberculosis household child contact investigation and management: a cluster randomized trial in Cameroon and Uganda. Lancet Glob Health. 2023;11:e1911-e1921. DOI: https://doi.org/10.1016/S2214-109X(23)00430-8
54. Lestari T, Graham S, van den Boogard C, Triasih R, Poespoprodjo JR, Ubra RR, et al. Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system strengthening study. Implementation Science. 2019;14:31. DOI: https://doi.org/10.1186/s13012-019-0870-x
55. Oxlade O, Benedetti A, Adjobimey M, Alsdurf H, Anagonou S, Cook VJ, et al. Effectiveness and cost-effectiveness of a health systems intervention for latent tuberculosis infection management (ACT4): a cluster-randomised trial. Lancet Public Health. 2021;6:e272-e282. DOI: https://doi.org/10.1016/S2468-2667(20)30261-9
56. Felisia F, Triasih R, Nabadan BWY, Sanjaya GY, Dewi SC, Rahayu ES, et al. High tuberculosis preventive treatment uptake and completion rates using a person-centred approach among tuberculosis household contacts in Yogyakarta. Trop Med Int Health. 2023;14:520. DOI: https://doi.org/10.3390/tropicalmed8120520
57. Marks GB, Nguyen NV, Nguyen PTB, Nguyen TA, Nguyen HB, Tran KH, et al. Community-wide screening for tuberculosis in a high-prevalence setting. N Engl J Med. 2019;381:1347-57. DOI: https://doi.org/10.1056/NEJMoa1902129
58. Fox GJ, Nhung NV, Sy DN, Hoa NLP, Anh LTN, Anh NT, et al. Household-contact investigation for detection of tuberculosis in Vietnam. N Engl J Med. 2018;378:221-9. DOI: https://doi.org10.1056/NEJMoa1700209
59. Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2013;41:140-56. DOI: https://doi.org/10.1183/09031936.00070812 Erratum in: Eur Respir J. 2015;46:578. DOI: https://doi.org/10.1183/13993003.50708-2012
60. Pank N, Aung A, Kama G, Murray A, Huang KL, Greig J, et al. Continuous quality improvement in a community-wide TB screening and prevention program in Papua New Guinea. Public Health Action. 2024;14:97-104. DOI: https://doi.org/10.5588/pha.24.0013
61. Coleman M, Nguyen TA, Luu BK, Hill J, Ragonnet R, Trauer JM, et al. Finding and treating both tuberculosis disease and latent infection during population-wide active case finding for tuberculosis elimination. Front Med (Lausanne). 2023;10:1275140. DOI: https://doi.org/10.3389/fmed.2023.1275140
2. Kementerian Kesehatan Republik Indonesia. Revised national strategy of tuberculosis care and prevention in Indonesia 2020-2024 and interim plan for 2025-2026. [cited 2025 Jan 5]. Available from: https://www.tbindonesia.org.id/wp-content/uploads/2024/02/Revised-NSP-TB-2020-2024-and-interim-plan-2025-2026_final_ttd-1.pdf
3. Martinez L, Cords O, Horsburgh CR, Andrews JR; Pediatric TB Contact Studies Consortium. The risk of tuberculosis in children after close exposure: a systematic review and individual-participant meta-analysis. Lancet. 2020;395:973-84. DOI: https://doi.org/10.1016/S0140-6736(20)30166-5
4. Noviyani A, Nopsopon T, Pongpirul K. Variation of tuberculosis prevalence across diagnostic approaches and geographical areas of Indonesia. PLoS ONE. 2021;16:e0258809. DOI: https://doi.org10.1371/journal.pone.0258809
5. Kementerian Kesehatan Republik Indonesia and WHO. Indonesia TB Joint External Monitoring Mission Report, 4-15 December 2022. [cited 2024 Dec 4]. Available from: https://domes.un.or.id/api/v1/download?filename=keshif/474cac0e-8df0-449b-a771-f2bcde6056d6.pdf
6. WHO consolidated guidelines on tuberculosis. Module 5: Management of tuberculosis in children and adolescents. Geneva: World Health Organization; 2022 [cited 2024 Dec 6]. Available from: https://www.who.int/publications/i/item/9789240046764
7. WHO operational handbook on tuberculosis. Module 5: Management of tuberculosis in children and adolescents. Geneva: World Health Organization; 2022 [cited 2024 Dec 6]. Available from: https://www.who.int/publications/i/item/9789240046832
8. Olbrich L, Franckling-Smith Z, Larsson L, Sabi I, Ntinginya NE, Khosa C, et al; RaPaed-AIDA-TB consortium. Sequential and parallel testing for microbiological diagnosis of tuberculosis disease in children in five low-income and middle- income countries: a secondary analysis of the RaPaed-TB study. Lancet Infect Dis. 2024:S1473-3099(24)00494-8. DOI: https://doi.org/10.1016/S1473-3099(24)00494-8
9. Chani K, Athallah A, Colquhoun S, Tsheten T, Huang K, Chirenda J, et al. Proportions of Xpert Ultra trace result vary widely among populations with presumptive tuberculosis: a systematic review. Int J Tuberc Lung Dis . 2025 (in press)
10. Lestari BW, Mc Allister S, Hadisoemarto PF, Afifah N, Jani ID, Murray M, et al. Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia. Lancet Reg Health West Pac. 2020;5:100059. DOI: https://doi.org/10.1016/j.lanwpc.2020.100059
11. Lestari BW, Hadisoemarto PF, Afifah N, McAllister S, Fattah D, Salindri AD, et al. Tuberculosis care provided by private practitioners in an urban setting in Indonesia: Findings from a standardized patient study. PLoS Glob Public Health. 2024;4:e0003311 DOI: https://doi.org/10.1371/journal.pgph.0003311
12. de Haas P, Nhung NV, Hng NT, Hoà NB, Loan NB, Thanh NTK, et al. Introduction of the simple one-step stool Xpert Ultra method to detect TB in children and adults. Int J Tuberc Lung Dis 2023;27:19-27. DOI: https://doi.org/10.5588/ijtld.22.0161
13. Mafirakureva N, Klinkenberg E, Spruijt I, Levy J, Shaweno D, de Haas P, et al. Xpert Ultra stool testing to diagnose tuberculosis in children in Ethiopia and Indonesia: a modelbased cost-effectiveness analysis. BMJ Open. 2022;12:e058388. DOI: https://doi.org/10.1136/bmjopen-2021-058388
14. Evident Indonesia. Evaluasi dan demonstrasi modalitas diagnostik baru untuk penyakit tuberkulosis di Indonesia. [cited 2024 Dec 9]. Available from: www.evident.rc3id.unpad.ac.id
15. The Union. Diagnosis and management of tuberculosis in children and adolescents. A desk guide for primary health care workers. Fourth edition. 2023. Graham SM, Oliwa JN. [cited 2024 Dec 6]. Available from: https://theunion.org/sites/default/files/2023-02/Child%20TB%20Desk%20Guide%202023_Asia.pdf
16. Gunasekera K, Marcy O, Munoz J, López-Varela E, Sekadde MP, Franke MF, et al. Development and validation of treatment-decision algorithms for children evaluated for pulmonary tuberculosis: an individual participant data meta-analysis. Lancet Child Adol Health, 2023;7:336-46. DOI: https://doi.org/10.1101/2022.09.13.22279911
17. Hatherill M, Hanslo M, Hawkridge T, Little F, Workman L, Mahomed H, et al. Structured approaches for the screening and diagnosis of childhood tuberculosis in a high prevalence region of South Africa. Bull World Health Organ. 2010;88:312-20. DOI: https://doi.org/10.2471/BLT.09.062893
18. Triasih R, Graham SM. Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation. Paediatr Indones. 2011;51:332-37. DOI: https://doi.org/10.14238/pi51.6.2011.332-7
19. Chabala C, Roucher C, Ton Nu Nguyet MH, Babirekere E, Inambao M, et al. Development of tuberculosis treatment decision algorithms in children below 5 years hospitalised with severe acute malnutrition in Zambia and Uganda: a prospective diagnostic cohort study. EClinMed. 2024;73:102688. DOI: https://doi.org/10.1016/j.eclinm.2024.102688
20. Triasih R, Yani FF, Wulandari DA, Nababan B, Ardiyamustaqim MB, Meyanti F, et al. Treatment-decision algorithm of child TB: evaluation of WHO algorithm and development of Indonesia algorithm. Trop Med Int Health. 2025. Not peer-reviewed version. DOI: https://doi.org/10.20944/preprints202501.0256.v1
21. du Preez K, Gabardo BMA, Kabra SK, Triasih R, Lestari T, Kal M, et al. Priority activities in child and adolescent tuberculosis to close the policy-practice gap in low- and middle-income countries. Pathogens. 2022;11:196 DOI: https://doi.org/10.3390/pathogens11020196
22. The Union. Diagnostic CXR atlas for tuberculosis in children. A guide to chest X-ray interpretation. Second Edition. 2022. Palmer M, Seddon JA, Goussard P, Schaaf HS. [cited 2025 Jan 5]. Available from: https://theunion.org/sites/default/files/2022-03/The%20Union_Diagnostic%20Atlas%20for%20TB%20in%20Children_2022.pdf
23. The Union. Online course for interpretation of CXRs in children with presumptive TB. [cited 2024 Oct 10]. Available from: https://coursesonline.theunion.org/theunion/2023/interpretation-of-chest-x-rays-in-children-with-tb/393947
24. The Union. Diagnostic CXR atlas for tuberculosis in children - image library. [cited 2024 Oct 10]. Available from: https://atlaschild.theunion.org/
25. The Union. Atlas radiografi toraks untuk diagnosis tuberkulosis pada anak. Sebuah panduan untuk interpretasi radiografi toraks. Edisi kedua. 2022. [cited 2024 Oct 10]. Available from: https://theunion.org/technical-publications/diagnostic-cxr-atlas-for-tuberculosis-in-children-bahasa-indonesia Accessed October 10, 2024.
26. Palmer M, Seddon JA, van der Zalm MM, Hesseling AC, Goussard P, Schaaf HS, et al. Optimising computer aided detection to identify intra-thoracic tuberculosis on chest x-ray in South African children. PLoS Glob Public Health. 2023;3:e0001799. DOI: https://doi.org/10.1371/journal.pgph.0001799
27. Edem VF, Nkereuwem E, Agbla SC, Owusu SA, Sillah AK, Saidy B, et al. Accuracy of CAD4TB (Computer Aided Detection for Tuberculosis) on paediatric chest radiographs. Eur Respir J. 2024;64:2400811. DOI: https://doi.org/10.1183/13993003.00811-2024
28. Zawedde-Muyanja S, Nakanwagi A, Dongo JP, Sekadde MP, Nyinoburyo R, Ssentongo G, et al. Decentralisation of child tuberculosis services increases case finding and uptake of preventive therapy in Uganda. Int J Tuberc Lung Dis. 2018;22:1314-21. DOI: https://doi.org/10.5588/ijtld.18.0025
29. Lestari T, Kamaludin, Lowbridge C, Kenangalem E, Poespoprodjo JR, Graham SM, et al. Impacts of tuberculosis services strengthening and the COVID-19 pandemic on case detection and treatment outcomes in Mimika District, Papua, Indonesia: 2014-2021. PLoS Glob Pub Health. 2022;2:e0001114. DOI: https://doi.org/10.1371/journal.pgph.0001114
30. OpenWHO.e-course Management of tuberculosis in children and adolescents for health care workers. [cited 2024 Oct 20]. Available from: https://openwho.org/courses/TB-child-adolescent-EN
31. OpenWHO. E-learning course on TB in children and adolescents: programmatic considerations. [cited 2024 Oct 20]. Available from: https://openwho.org/courses/TB-child-adolescent-programmatic
32. The Union. Management of Child and Adolescent TB, Union Courses Online. [cited 2024 Dec 6]. Available from: https://coursesonline.theunion.org/
33. Badan Kebijakan Pembangunan Kesehatan, Kementrian Kesehatan RI. Buku Saku Hasil Survei Status Gizi (SSGI) 2022. [cited 2025 Jan 5]. Available from: https://drive.google.com/file/d/1v6ceJlVFCVCBedrzbdDNCj6T4ZbadVBi/view
34. Chisti MJ, Graham SM, Duke T, Ahmed T, Ashraf H, Faruque ASG, et al. A prospective study of the prevalence of tuberculosis and bacteraemia in Bangladeshi children with severe malnutrition and pneumonia including an evaluation of Xpert MTB/RIF assay. PLoS One. 2014;9:e93776 DOI: https://doi.org/10.1371/journal.pone.0093776
35. Podewils LJ, Holtz T, Riekstina V, Skripconoka V, Zarovska E, Kirvelaite G, et al. Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients. Epidemiol Infect. 2011;139:113-120. DOI: https://doi.org/10.1017/S0950268810000907
36. Bhargava A, Chatterjee M, Jain Y, Chatterjee B, Kataria A, Bhargava M, et al. Nutritional status of adult patiens with pulmonary tuberculosis in rural central India and its association with mortality. PLoS One. 2013;8:e77979. DOI: https://doi.org/10.1371/journal.pone.0077979
37. Hoyt KJ, Sarkar S, White L, Joseph NM, Salgame P, Lakshminarayanan S, et al. Effect of malnutrition on radiographic findings and mycobacterial burden in pulmonary tuberculosis. PLoS One. 2019;14:e0214011. DOI: https://doi.org/10.1371/journal.pone.0214011
38. Putri FA, Burhan E, Nawas A, Soepandi PZ, Sutoyo DK, Agustin H, et al. Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia. Int J Tuberc Lung Dis. 2014;18:564-570. DOI: https://doi.org/10.5588/ijtld.13.0602
39. Bhargava A, Bhargava M, Meher A, Benedetti A, Velayutham B, Sai Teja G, et al. Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial. Lancet. 2023;402:627-40. DOI: https://doi.org/10.1016/S0140-6736(23)01231-X Erratum in: Lancet. 2024;404:340. DOI: https://doi.org/10.1016/S0140-6736(24)01500-9
40. Bhargava A, Bhargava M, Meher A, Teja GS, Velayutham B, Watson B, et al. Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India. Lancet Glob Health. 2023;11:e1402-e1411. DOI: https://doi.org/10.1016/S2214-109X(23)00324-8
41. Obimbo Maleche E, Atieno Odhiambo M, Njeri L, Mburu M, Jaoko W, Were F, et al. Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries: a systematic review and meta-analysis. PLoS Glob Public Health. 2022;2:e0000805 DOI: https://doi.org/10.1371/journal.pgph.0000805
42. Martinez L, Gray DM, Botha M, Nel M, Chaya S, Jacobs C, et al. The long-term impact of early-life tuberculosis disease on child health: A prospective birth cohort study. Am J Respir Crit Care Med. 2023;207:1080-8. DOI: https://doi.org/10.1164/rccm.202208-1543OC
43. Nkereuwem E, Agbla S, Njai B, Edem VF, Jatta ML, Owolabi O, et al. Post-tuberculosis respiratory impairment in Gambian children and adolescents: A cross-sectional analysis. Pediatr Pulmonol. 2024;59:1912-21. DOI: https://doi.org/10.1002/ppul.27009
44. du Preez K, Jenkins HE, Martinez L, Chiang SS, Dlamini SS, Dolynska M, et al. The global burden of tuberculous meningitis in children aged 0-14 years: a mathematical modelling study. Lancet Glob Health. 2025;13:e59-e68. DOI: https://doi.org/10.1016/S2214-109X(24)00383-8
45. Wasserman S, Donovan J, Kestelyn E, Watson JA, Aarnoutse RE, Barnacle JR, et al. Advancing the chemotherapy of tuberculous meningitis: a consensus view. Lancet Infect Dis. 2025;25:e47-e58. DOI: https://doi.org/10.1016/S1473-3099(24)00512-7 Erratum in: Lancet Infect Dis. 2025;25:e13. DOI: https://doi.org/10.1016/S1473-3099(24)00829-6
46. WHO consolidated guidelines on tuberculosis. Module 1: Prevention - tuberculosis preventive treatment. Second edition. Geneva: World Health Organization; 2024 [cited 2024 Jan 5]. Available from: https://www.who.int/publications/i/item/9789240096196
47. Martinez L, Cords O, Liu Q, Acuna-Villaorduna C, Bonnet M, Fox GJ, et al. Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis. Lancet Glob Health. 2022;10:e1307-e1316. DOI: https://doi.org/10.1016/S2214-109X(22)00283-2
48. Kementerian Kesehatan Republik Indonesia. Annual Report Immunization 2022. [cited 2024 Dec 6]. Available from: https://p2p.kemkes.go.id/wp-content/uploads/2023/12/FINAL_231123_Layout_Imunisasi_Bahasa-Inggris.pdf
49. Tait DR, Hatherill M, Van Der Meeren O, Ginsberg AM, Van Brakel E, Salaun B, et al. Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis. N Engl J Med. 2019;381:2429-39. DOI: https://doi.org/10.1056/NEJMoa1909953
50. Late-stage trial for tuberculosis vaccine candidate underway in South Africa. [cited 2024 Oct 11]. Available from: https://wellcome.org/news/late-stage-trial-tuberculosis-vaccine-candidate-underway-south-africa
51. Martinez L, Seddon JA, Horsburgh CR, Lange C, Mandalakas AM; TB Contact Studies Consortium. Effectiveness of preventive treatment among different age groups and Mycobacterium tuberculosis infection status: a systematic review and individual-participant data meta-analysis of contact tracing studies. Lancet Resp Med 2024;12:633-41. DOI: https://doi.org/10.1016/S2213-2600(24)00083-3
52. Fox GJ, Nguyen VN, Nguyen CB, Nguyen BH, Garden FL, Benedetti A, et al. Levofloxacin for the prevention of multidrug-resistant tuberculosis in Vietnam. New Engl J Med. 2024;391:2304-14. DOI: https://doi.org/10.1056/NEJMoa2314325
53. Bonnet M, Vasiliu A, Tchounga BK, Cuer B, Fielding K, Ssekyanzi B, et al. Effectiveness of a community-based approach for tuberculosis household child contact investigation and management: a cluster randomized trial in Cameroon and Uganda. Lancet Glob Health. 2023;11:e1911-e1921. DOI: https://doi.org/10.1016/S2214-109X(23)00430-8
54. Lestari T, Graham S, van den Boogard C, Triasih R, Poespoprodjo JR, Ubra RR, et al. Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system strengthening study. Implementation Science. 2019;14:31. DOI: https://doi.org/10.1186/s13012-019-0870-x
55. Oxlade O, Benedetti A, Adjobimey M, Alsdurf H, Anagonou S, Cook VJ, et al. Effectiveness and cost-effectiveness of a health systems intervention for latent tuberculosis infection management (ACT4): a cluster-randomised trial. Lancet Public Health. 2021;6:e272-e282. DOI: https://doi.org/10.1016/S2468-2667(20)30261-9
56. Felisia F, Triasih R, Nabadan BWY, Sanjaya GY, Dewi SC, Rahayu ES, et al. High tuberculosis preventive treatment uptake and completion rates using a person-centred approach among tuberculosis household contacts in Yogyakarta. Trop Med Int Health. 2023;14:520. DOI: https://doi.org/10.3390/tropicalmed8120520
57. Marks GB, Nguyen NV, Nguyen PTB, Nguyen TA, Nguyen HB, Tran KH, et al. Community-wide screening for tuberculosis in a high-prevalence setting. N Engl J Med. 2019;381:1347-57. DOI: https://doi.org/10.1056/NEJMoa1902129
58. Fox GJ, Nhung NV, Sy DN, Hoa NLP, Anh LTN, Anh NT, et al. Household-contact investigation for detection of tuberculosis in Vietnam. N Engl J Med. 2018;378:221-9. DOI: https://doi.org10.1056/NEJMoa1700209
59. Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2013;41:140-56. DOI: https://doi.org/10.1183/09031936.00070812 Erratum in: Eur Respir J. 2015;46:578. DOI: https://doi.org/10.1183/13993003.50708-2012
60. Pank N, Aung A, Kama G, Murray A, Huang KL, Greig J, et al. Continuous quality improvement in a community-wide TB screening and prevention program in Papua New Guinea. Public Health Action. 2024;14:97-104. DOI: https://doi.org/10.5588/pha.24.0013
61. Coleman M, Nguyen TA, Luu BK, Hill J, Ragonnet R, Trauer JM, et al. Finding and treating both tuberculosis disease and latent infection during population-wide active case finding for tuberculosis elimination. Front Med (Lausanne). 2023;10:1275140. DOI: https://doi.org/10.3389/fmed.2023.1275140
Published
2025-02-24
How to Cite
1.
Graham S, Dwihardiani B, Felisia F, Koesoemadinata R, Putri N, Alisjahbana B, Lestari T, Yani F, Triasih R. Challenges and opportunities to improve tuberculosis care for Indonesian children. PI [Internet]. 24Feb.2025 [cited 19Mar.2025];65(1). Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3955
Section
Editorial
Copyright (c) 2025 Stephen M. Graham, Bintari Dwihardiani, Felisia Felisia, Raspati Cundarani Koesoemadinata, Nina Dwi Putri, Bachti Alisjahbana, Trisasi Lestari, Finny Fitri Yani, Rina Triasih
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2025-01-06
Accepted 2025-02-24
Published 2025-02-24
Accepted 2025-02-24
Published 2025-02-24
